The Changes of Biochemical Bone Markers in Pediatric Epileptic Children Who Received Long-term Antiepileptic Drugs and Usefullness Thereof

Choi, Eun Kyung; Kim, Kyung Hee; Kim, Sun Jun

Abstract

PURPOSE
Long-term administration of anticonvulsants for pediatric epileptic patients may cause changes of bone metabolism. This study was performed to evaluate the influence of antiepileptics on the bone metabolism and growth in pediatric patients who received antiepileptics. Methods for early detection of adverse bone metabolism were also evaluated.
METHODS
Forty-eight epileptic patients were enrolled in this study. All subjects had taken antiepileptics for at least 6 months. Subjects were grouped according to the antiepileptics : Group I(n= 31) was treated with carbamazepine(CBZ), Group II(n=9) used valproic acids(VPA), Group III(n=8) received multi-drugs including CBZ, VPA. We determined serum osteocalcin and total alkaline phosphatase levels as markers of bone formation, and urinary deoxypyridinoline as marker of bone resorption. Blood and urine samples were collected before the initial medication and follow up at least 6 months later. Serum osteocalcin and urinary deoxypyridinoline were measured by an ELISA method, respectively. Data from subjects were analyzed statistically by SPSS(ver. 10).
RESULTS
Concentrations of serum osteocalcin and urinary deoxypyridinoline were significantly increased in the carbamazepine treated group. The increment of deoxypyridinoline positively correlated with the duration of treatment, especially in children who received carbamazepine therapy for more than 12 months(P<0.05). The serum concentration of calcium, phosphorus were within normal ranges, but the levels of alkaline phosphatase were significantly increased in all group(P<0.05).
CONCLUSION
Our data suggests that serum osteocalcin and alkaline phosphatase, urinary deoxypyridinoline could be useful markers for the early detection of harmful bone metabolism during antiepileptic treatment.